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What is it?                                            this purpose than other oils containing GLA
                                                       such as borage or black currant oil. Evening
 Evening primrose oil is made from the seeds of        primrose oil has not been studied as a
 Oenothera biennis or evening primrose. This           treatment for peripheral neuropathy in people
 plant is a tall biennial that is native to North      with HIV. Nevertheless, nutritionists like Lark
 America. Evening primrose oil is rich in a            Lands recommend GLA supplements in
 substance called gamma-linolenic acid (GLA),          combination with B-complex vitamins, vitamin
 which contributes to many important functions         E and omega-3 fatty acid supplements for
 in the body. GLA is normally created during the       PHAs suffering from neuropathy.
 breakdown of omega-6 fatty acids inside the
 body. Omega-3 and omega-6 fatty acids are             2. To treat skin conditions associated with
 essential fatty acids. They are called essential      anti-HIV drugs
 because they must be included in the diet since       Some anti-HIV drugs can cause dry skin and
 our body can’t make them. In theory, chronic          itching, symptoms most commonly associated
 viral infections, such as HIV, may impair the         with indinavir (Crixivan). Electronic forums
 body’s ability to convert omega-6 fatty acids into    such as PI-treat and Crix-list contain anecdotal
 GLA. Evening primrose oil may, therefore, be          reports that describe improvements in these
 useful to ensure adequate levels of GLA in the        symptoms with the use of evening primrose
 body. It may have other uses as well.                 oil. According to such anecdotes, two grams
                                                       a day is generally recommended. Evening
What do people with HIV use                            primrose oil is also used to treat eczema and
this supplement for?                                   dermatitis in HIV-negative people. Although
                                                       some studies have not shown an improvement,
 1. To help heal nerve damage (peripheral              an analysis of nine different trials showed that
 neuropathy)                                           evening primrose oil significantly improved
 Peripheral neuropathy (PN) is a burning or            dermatitis. The improvements continued over
 tingling in the hands and feet. It is associated      time and were greater when higher doses were
 with the use of the anti-HIV drugs ddI, d4T           used. Evening primrose oil was, however, less
 and ddC. PN also occurs in people with                successful at relieving the itch caused by this
 diabetes. Several trials have shown that              condition.
 evening primrose oil can help relieve the             3. To cope with premenstrual syndrome
 symptoms of diabetic PN. In one study, 22
 people who took four grams of evening                 Compared with women not infected with HIV,
 primrose oil daily for six months had a               many HIV-positive women have heavier periods
 significant improvement in symptoms. Evening          and more intense symptoms of premenstrual
 primrose oil appears to be more effective for         syndrome, such as pain and bloating. Evening

                                                                              CATIE FactSHEET
                                                                      Evening Primrose Oil, page 1 of 3
 primrose oil is commonly used in Britain to          omega-3 fatty acid like flaxseed oil in order to
 treat these symptoms. Naturopaths generally          balance their intake of essential fatty acids.
 suggest four to six months of use in order for
 symptoms to improve.                                 Evening primrose should not be taken by people
                                                      with mental illness who experience mania
 4. To reduce cholesterol levels                      because it may make this condition worse.
                                                      People with epilepsy or other people who
 In recent years, many PHAs have experienced          experience seizures should take it cautiously
 elevated levels of cholesterol that may be linked    because it has been associated with an
 to the use of anti-HIV drugs, particularly           increased frequency of seizures in a few case.
 protease inhibitors. Evening primrose has
 helped decrease cholesterol in HIV-negative          Evening primrose oil should be used cautiously
 people. One British study using three to four        by people taking drugs that reduce blood
 grams of evening primrose oil for 12 weeks           clotting, such as aspirin. In theory, evening
 showed significant benefit. Both men and             primrose oil may be less effective in people
 women participated in the study. The                 taking beta-blockers, which are drugs used
 treatment was most effective in those                to treat high blood pressure.
 participants with the most abnormal
 cholesterol levels. In the subjects with the        Credits
 highest cholesterol levels at the start of the
 study, total cholesterol levels decreased by 30      Author: Lori Lyons
 per cent. The potential of evening primrose          Created: April 2002
 oil to reduce cholesterol levels in PHAs taking
 protease inhibitors has not been studied.            Design: Renata Lipovitch

Available forms and usage                            References
 Evening primrose oil is usually sold in capsules     Boon H, Smith M. The Botanical Pharmacy. Kingston: Quarry
                                                      Health Books, 1999.
 or as a liquid. It should contain a minimum of
                                                      Horrobin DF, Manku MS. How do polyunsaturated fatty acids
 eight per cent gamma-linolenic acid. PHAs            lower plasma cholesterol levels. Lipids 1983;18:558-62.
 usually take two grams a day with food, divided
                                                      Lands Lark. Nutrient therapy for neuropathy, 1999. Available
 into several doses. People experiencing              at: http://www.aids.org/daair/
 peripheral neuropathy may take doses as high
                                                      Morse PF, Horrobin DF et al. Meta-analysis of placebo-controlled
 as four grams. To prevent the oxidation of           studies of the efficacy of Epogram on the treatment of atopic
 evening primrose oil, at least 400 IU/day of         eczema. British Journal of Dermatology 1989;121:75-90.
 vitamin E should also be taken with meals.           Nemecz G. Evening Primrose. US Pharmacist 1998 Nov.
 Evening primrose oil is now widely available         Available at: http://www.uspharmacist.com/
 and can be purchased from herbalists or from         Puolakka J, Makarainen L et al. Biochemical and clinical effects
 health food or drug stores.                          of treating the premenstrual syndrome with prostaglandin
                                                      synthesis precursors. Journal of Reproductive Medicine 1985
Cautions and concerns
 Evening primrose oil is generally considered
 quite safe. Rare adverse effects include
 nausea, headache and diarrhea.
 Evening primrose oil may have an effect on the
 immune system but these results have been
 inconclusive and sometimes contradictory. Some
 nutritionists recommend that PHAs take evening
 primrose oil (omega-6) in combination with an

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                                                                          Evening Primrose Oil, page 2 of 3
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                                                                                         Evening Primrose Oil, page 3 of 3